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post 1334 is a classic.

MrSuccess

uprightdoc wrote:Dania,
What you are describing makes a great deal of sense. The scar tissue may be compressing or tensioning the spinal accessory nerve in the jugular bulb. The spinal accessory nerve controls the trapezius and SCM muscles. Abnormal tension in the traps and SCM can affect the suboccipital cavernous sinus which contains the vertebral arterys supply to the brain. Typically doctors don't check neck muscles very carefully. I prefer to test the SCM with patient supine to isolate the muscle. I test them but traps are more difficult to test, very strong and easy to recruit other muscles. On the lower end of the neck, abnormal and imbalances in the traps and SCM can distort the thoracic outlet which contains the blood vessels and nerves to the arms.

I would ask your neurologist to test your traps and SCM muscles. I would also consider consulting with a neuroradiologist to see if he can image and investigate the lump. The jugular bulb and base of the skull are complex. You should also let the neuro and radiologist know about the feeling of passing out when you move your neck a certain way. It may be a sign of beauty parlor syndrome. This will clue the radiologist in to look for possible signs of ischemia. You should also let the chiropractor know so he can work the suboccipital area gently to decrease the tension on the base of the skull and upper cervical spine.

Sent my question and your response to my neurologist. This was his response.
I am sorry I am not expert to take on this problem. You may need to start with a CLSC or emergency department if there is no one else.

I already asked my doctor from the CLSC and she asked have you seen your neurologist?
That's the problem once diagnosed with MS, every complaint is blamed on MS. I just get tossed from one doctor to another. Nobody is taking my complaint seriously and that is has nothing to do with MS. So now what do I do?

uprightdoc wrote:Nigel, I agree with everything you said and I understand what you are saying about what MS is and isn't. The label is often misused and it can be misleading when it comes to the cause and treatment. MS is clearly a neurodegenerative condition, which is easy demonstrate, and so it should be categorized as such. It should not be categorized as an autoimmune-inflammatory conditon, which is just a theory.

I agree that when 'MS' fell into the auto-immune excuses for not looking further pile that was when things came to a halt with the MS learning curve.
If the researchers had stayed with the search for cause of inflammation they would have been at the same point in the MS knowledge curve they are now but 60 odd years ago.

There is progress with the MS knowledge curve that is re-inflamed by CCSVI researchers seeing that inflammation and infection go hand in hand or hand in glove like the symptoms of porphyria and MS.

Slowly getting there!

;)
Nigel

I'm glad you enjoyed post 1334 Mr. Success. You must like egg heads. Egg heads are very anal - so much so that sometimes they can't see the forest through the trees because their heads are buried deep where the sun don't shine. I have seen some phenomenal poroelasticity studies by engineers that were based on gross wrong assumptions they used in their models such as fixed borders of the brain and non-porous, non-compliant cranial vaults. The biggest miscalculation, however, is that most studies have been done supine. It doesn't take a rocket scientist to see the difference that upright posture causes in fluid mechanics. Humans spend two-thirds of their lives upright and upright posture significantly changes cranial and spinal hydrodynamics. On the other hand, to be fair, egg heads have given us MRI, upright MRI and endoscopic surgery to name a few. Upright MRI is a game changer. The constantly changing programs, protocols and stronger equipment is providing more and more detail. Cine flow studies will improve as well.

There are many causes of neurodegenerative conditions that are only indirectly related to inflammation. Strokes and ischemic primarily cause damage are due to lack of blood flow. Inflammation is a byproduct of the problem. Hydrocephalus and edema cause compression and stretch neuropathies. Chiari malformations, stenosis, disc herniations etc also cause compression neuropathies. Ligament laxity and joint instabilities, called listhesis, cause stretch neuropathies. Inflammation is a process not a disease. It causes problems when it gets out of control. There are many causes of inflammation. Infection is just one. Burns, scrapes and bruises cause inflammation. Chronic ischemia causes inflammation such as myofascitis in muscles and connective tissues. Atopy and allergies likewise cause histamine reactions and inflammation as part of an over-reactive defense mechanism. For the most part, inflammation is a byproduct of most neurodegenerative conditions, not the cause of it.

Dania,
You could also ask your doctor to send your for a doppler scan of your vertebral-basilar artery. In the meantime, tell the chiropractor about your symptoms of weakness and light headedness when you turn and extend your head and neck. Have him check and see if he can gently stretch and rehabilitate the suboccipital area and scar tissue to relieve the tension and compression.

Dr Flanagan:

Given your explanations quoted below, do you believe that most spinal cord MS lesions are due to CSF circulation problems? (and not vein/valve stenoses)?
Is it possible for restenosis of the jugular veins after angioplasty to be caused by CSF pressure?
Is it possible to have CSF problems in the spine as well as vein stenosis valve problems in the veins draining the brain, (that is to say 2 separate problems?)

Who is best equipped to study and treat the CSF problems? Chiropractors in the US? What specialty? Do Osteopaths treat this in the US as well?
In France Osteopaths perform body structure and CSF problems (more or less), but they don’t use x-rays. Also, the French find American Chiropractic to be “very violent” which scares people off.
(there are American chiropractors in Paris) Are American Osteopaths equipped and capable to deal with these problems? Or maybe I should simply ask:

What should MS patients do to study the issue and find treatment? To whom should they address themselves? What should they ask for? (Doubtless the issue is very complicated, but you have to start somewhere.)

(Here is an example of good Osteopathic treatment as performed in France/Recently I was treated by an outstanding Osteopath. He is the official Osteopath for a championship French sports team and is accustomed to putting dislocated muscles and bones back into place. When I arrived I could barely walk and wondered if my nervous system was failing me. No, upon leaving my legs moved freely. And think of it this way. The muscles were so tightly compressed around my pelvic region that they literally prevented my legs from moving. Like a horror film, I could imagine my entire musculature shrinking, compressing my skeleton to the point I was becoming immobilized. He said there was so much tension built into the shoulder/neck/head area that the muscles were compressing all circulation from the head like a vise. So if I think of what these muscles are doing to fluid circulation through my neck, head, and spine I can well imagine a blood reflux injury to the central nervous system - a good definition of MS?)

Thank you.

“Upright doc june 25 2013

I understand Dr. Scalfani's point as to why he prefers angio and IVUS for determing venous flow problems due to stenosis and faulty valves. Angio and IVUS are certainly much better at assesing those types of stenosis and blood flow problems. On the other hand, angio and IVUS are not the preferred method of diagnosing stenosis of the spine and obstruction to CSF flow as a result of increased venous pressure in the VVP due to spondylosis, stenosis and scoliosis of the spinal canal. Spondylosis, stenosis and scoliosis affect the design of the canal, which affects hydrodynamics and CSF flow in the cranial vault and spinal canal. The faulty hydrodynamics get worse during upright posture. X-rays and upright MRI are much better than angio or IVUS for determining these problems.

The other point is that angio and IVUS don't rule out potential structural causes of obstruction to venous flow into the VVP during upright posture. Venous blood preferentially drains into the VVP during upright posture, not the IJs. The upper cervical canal is a key point of obstruction. Angiograms also expose patinets to much more radiation than basic x-rays of the spine and MRI so it makes more sense to get them first to rule out and fix potential structural problems first, espeically if they obviate the need for further more invasive intervention. Treating underlying structural problems may also help improve the durability of venoplasty and stents when necessary. Certain structural problems may also help surgeons better choose between venoplasty versus shunts, such as in a case like CurIous associated with cervical kyphosis and deformation by the transverse process of atlas. I further suspect that venous insufficiency in the azygous and iliac veins can similarly be caused by structural issues sucha as spondylosis, stenosis and scoliosis of the lower spine due to their impact on myofascial tunnels and pressure gradients.

June 25 9:28 am
Structural issues in the spine that affect blood and CSF flow in the cranial vault and spinal canal are far more common and likely a cause of MS, as well as other neurodegenerative diseases than problems in the jugular veins or TMJ for that matter. It makes sense that lesions are often found in the area of spondylosis, bone spurs and stenosis. Spondylosis, stenosis and scoliosis alter the design of the tunnel of the spinal canal. When you change the dimensions and design of a tunnel or pipe you alter the flow of fluids through it. It's basic physics. Although he is a leading expert geotechical engineer and thinks in terms of stone and soil stability so much so that it takes time to sink in like water passing through thick clay, even, my tunneling expert brother gets it. I just have to speak slowly and repeat myself many times. He's been digging around NZ lately Nigel so you better stock up on some caulk and keep an eye out for sink holes.

Hello Vesta,
The VVP is the Vertebral Venous Plexus. Upright posture increases blood flow in and out of the brain which required modifications to the basic drainage system used by mammals. During upright posture, the human brain primarily switches over to the occipital marginal sinus, emissary and accessory venous system that drains into the VVP inside the spinal canal and around the spine. The accessory veins and outlets are the lowest drainage points in the posterior fossa.

Vesta, June 26, 2013
I think that violent venous and CSF backjets due to trauma such as whiplash as proposed by Dr. Schelling is a possible cause of the supratentorial, periventricular and perivenular lesions seen in MS. Chronic ischemia, edema and increased CSF volume due to poor drainage are other causes. Lesions can also be caused by autoimmune-inflammatory conditions and infections.

June 29, 2013
There are many causes of neurodegenerative conditions that are only indirectly related to inflammation. Strokes and ischemic primarily cause damage are due to lack of blood flow. Inflammation is a byproduct of the problem. Hydrocephalus and edema cause compression and stretch neuropathies. Chiari malformations, stenosis, disc herniations etc also cause compression neuropathies. Ligament laxity and joint instabilities, called listhesis, cause stretch neuropathies. Inflammation is a process not a disease. It causes problems when it gets out of control. There are many causes of inflammation. Infection is just one. Burns, scrapes and bruises cause inflammation. Chronic ischemia causes inflammation such as myofascitis in muscles and connective tissues. Atopy and allergies likewise cause histamine reactions and inflammation as part of an over-reactive defense mechanism. For the most part, inflammation is a byproduct of most neurodegenerative conditions, not the cause of it.”

uprightdoc wrote:Dania,
You could also ask your doctor to send your for a doppler scan of your vertebral-basilar artery. In the meantime, tell the chiropractor about your symptoms of weakness and light headedness when you turn and extend your head and neck. Have him check and see if he can gently stretch and rehabilitate the suboccipital area and scar tissue to relieve the tension and compression.

TY. I will tell my chiro. I am afraid telling my doctor will result in nothing. She is convinced my problem is MS. I showed one of the women who help me my trick to get up, before and after stretching my spine and tucking my head to my chest, before could not lift my body 1 inch off my W/C and after, stood up straight and tall in 1 second. She was shocked. Another question, can the scar tissue be removed/eliminated. Also my vision brightness and clarity vary with my position of my neck and my sense of smell and taste has been altered.

.... Given your explanations quoted below:
1) do you believe that most spinal cord MS lesions are due to CSF circulation problems? (and not vein/valve stenoses)?
2) Is it possible for restenosis of the jugular veins after angioplasty to be caused by CSF pressure?
3) Is it possible to have CSF problems in the spine as well as vein stenosis valve problems in the veins draining the brain, (that is to say 2 separate problems?)

4) Who is best equipped to study and treat the CSF problems? Chiropractors in the US? What specialty? Do Osteopaths treat this in the US as well?
In France Osteopaths perform body structure and CSF problems (more or less), but they don’t use x-rays. Also, the French find American Chiropractic to be “very violent” which scares people off.
(there are American chiropractors in Paris) Are American Osteopaths equipped and capable to deal with these problems? Or maybe I should simply ask:

5) What should MS patients do to study the issue and find treatment? To whom should they address themselves? What should they ask for? (Doubtless the issue is very complicated, but you have to start somewhere.)

(Here is an example of good Osteopathic treatment as performed in France/Recently I was treated by an outstanding Osteopath. He is the official Osteopath for a championship French sports team and is accustomed to putting dislocated muscles and bones back into place. When I arrived I could barely walk and wondered if my nervous system was failing me. No, upon leaving my legs moved freely. And think of it this way. The muscles were so tightly compressed around my pelvic region that they literally prevented my legs from moving. Like a horror film, I could imagine my entire musculature shrinking, compressing my skeleton to the point I was becoming immobilized. He said there was so much tension built into the shoulder/neck/head area that the muscles were compressing all circulation from the head like a vise. So if I think of what these muscles are doing to fluid circulation through my neck, head, and spine I can well imagine a blood reflux injury to the central nervous system - a good definition of MS?) ...

1) Brain and cord lesions occur for a variety of reasons such as chronic ischemia, edema and faulty hydrodynamics, which includes CSF flow, in the cranial vault and spinal canal. Lesions can also occur due to traumatic brain injuries and violent blood and CSF inversion flows, as well as mechanical stresses that compresses or tension the brain and cord. Lastly, lesions can be caused by inflammation and infections.

2) Restenois after angioplasty cannot be caused by CSF pressure. Deformations of the spine and musculskeletal stres can increase extraluminal pressure, which can lead to re-stenosis.

3) Absolutely. Many patients with malformations of the craniocervical junction have vascular malformations. But I also think that patients without vascular problems can benefit from the siphon effect of venoplasty.

4) Becausse of the methods they use, some upper cervical doctors are better equiped to handle obstruction to blood and CSF flow in the craniocervical junction, which is very important. Craniosacral is based on mostly sound but also partly badly outdated theory that holds it back. Upper cervical chiropractors who still adhere to BJ Palmer's theory of a bone out of place pinching a nerve are just as bad. Flexion-distraction is an excellent tool but good tables are hard to find and most doctors aren't well educated in neurodegenerative diseases. Moreover, they are trained to use them in a very limited way for that is more suitable for musculoskeletal conditions not necessarily neurodegenerative diseases. It would be easy to switch over but they need to get educated about the conditions to apply the tool safely and effectively. Neurodegenerative conditions are far more complex and require careful consideration and caution.

5) Patients can get the ball rolling by educating themselves and discussing the subject with doctors other patients and people with influence. Blossom took on several top notch neurosurgeons. She must have left them scratching their heads - "Who was that women with the mask in the wheelchair who dropped this silver dime on my floor? " Dania speaks your language and is stirring thing up in merry old Quebec.

Neurosurgeons and neuroradiologists are experts on CSF flow.

The link below is to an article I ran across on the endangered Rothschild giraffe. I discuss the five horn Rothschild giraffe in my book. I have an excellent picture of an sagittal anatomical presentation of one from when I was at the Museum of Natural History in NY. My theory is that all giraffes use the diploic spaces and veins as accessory'alternate drainage routes during head inversion. The Rothschild giraffe is the largest and has accessory horns located in the premaxilla and suboccipital areas. I suspect that they similarly serve as accessory drainage routes to accomodate cranial hydrodynamics associated with head and neck inversion, as well as the return to the upright position. I have located my slides from the Museum of Natural History in NY of the pathological and deformed human crania as well as comparative anatomical studies of bats, whales and giraffes I studied. I am going to get them converted to digital format and use them for future craniosacral presentations. In contrast to bats and giraffes that use facial routes to contend with inversion, whales and dolphins use the VVP for inversion and Valsalva maneuvers. Humans use the VVP for upright posture.

http://www.ens-newswire.com/ens/aug2010 ... 19-01.html

From Alison Fisher and Alessandro Rassman,

"At rest, the brain receives approximately 14% of the cardiac output, around 700 ml per minute ( McArdle et al, 2006). The jugular veins therefore have to drain 700 ml per minute, a factor often overlooked. This is a sizeable volume, considering the average adult male intracranial volume (including brain and cerebrospinal fluid) is only twice this (1473 ml) (Abbott et al, 2000). Unlike the dual arterial system (carotid and vertebral systems), there is only one significant venous exit from the cranium, the internal jugular veins. Any compromise to this outflow (the small amount of pressure from a cervical collar or the increased intrathoracic pressures from positive pressure ventilation being common clinical examples) results in greater cerebral venous pressures and intracranial pressures. This phenomenon was recognized in 1935 (Bedford, 1935) and, while it is routinely seen in the setting of mechanical ventilation, the venous contribution to ICP is often overlooked."
http://online.liebertpub.com/doi/pdf/10 ... .2011.1026

Terrific paper Nigel.

The only two points I disagree with in the paper are that the internal jugular is the only significant drainage route and the other is that the occipital marginal sinus system is less robust and therefore drainage into the VVP isn't as efficient in humans as in hominids. It's actually a misinterpretation of Falk's paper. While it is true that the occipital marginal sinus system decreased in size in humans, other "accessory" emissary and venous routes, such as through the hypoglossal and condylar canals in the base of the skull and upper cervical spine, increased in size. I refer to the entire system including the occipital marginal sinus, emissary and other venous outlets collectively as the accessory drainage system. I called it that because of a paper I read years ago. Accessory is a misnomer. It's hardly accessory. Alternative would probably have been better. I use a cast of the veins of the brain in my presentations. They are far more extensive than the diagrams or venograms you see.

I communicated with Dr. Hargens awhile ago about my theory regarding venous and CSF inversion flows in astronauts. I cover both in the fantasy-philosophical last chapter of my book. The chapter was for fun, as well as food for thought. There are many pearls hidden within the pages of the book. The hydrocephalic, artificially deformed, pathologicals and comparative anatomical skulls provided me with many key forensic clues. It will take time for other scientists s to catch onto what bats, whales and giraffes taught me long ago.

My theory regarding the loss of vision experienced by certain astronauts is that they probably have tight iridocorneal angle designs in the eyes, which predisposes them to acute angle glaucoma due to inversion flows during microgravity. Unlike bats and giraffes, humans are poorly designed for inversion flows. We are designed for upright posture. In addition to glaucoma, I also maintain that astronauts would become hydrocephalic in space. Lastly, I suspect that some astronauts experience intracranial hypotenison when they return to earth due to a decrease in CSF volume in microgravity from loss of passive production and decreased volume in the lumbar cistern. It's why some develop drop attacks on re-entry. There is much more to cover. There would be faster progress if everyone was on the same page.

uprightdoc wrote:Neurosurgeons and neuroradiologists are experts on CSF flow.

they're not acting on their expertee or not following the dots or don't want to go out of the comfort zone or whatever. common sence should kick in here--especially with access to upright mri's. i'd be willing to bet the farm that if they took say dania or i and took a lying down position and let us position what we could our way--then an upright mri doing the same--and hear how they explain all the differences in flow etc. then observe us one on one positioning and movement. then block out their thoughts about ms totally of what they have been taught. if there would be even one ounce of common sence used they would have to conclude mechanical, structural - not a disease.. at least in mine and dania's case. and, many others.

Oct 1986
Damaging venous reflux into the skull or spine: relevance to multiple sclerosis.
Schelling F.
Abstract
Unequal propagation of central venous excess pressure into the different cerebral and spinal venous drainage systems is the rule rather than the exception. The intensity of the forces thus to be exerted on vulnerable cerebrospinal structures by the resulting pressure-gradients in the craniovertebral space is unknown. There is a need to consider the various conditions which may cause individual proneness to heavier reflux into particular cerebral as well as epi- and subdural spinal venous compartments. An attempt is made to indicate eventual consequences of excessive retrograde dilatation especially of internal cerebral veins. The importance of elucidating the neuropathological and clinical implications of undue reflux into the skull or spine is deduced from the probability of relations between localized backflow into the craniovertebral space and unexplicated cerebrospinal diseases. In this regard the features of multiple sclerosis are discussed.
http://www.ncbi.nlm.nih.gov/pubmed/3641027

;)
Nigel